Your Questions

Infertility is the inability of a heterosexual couple to achieve pregnancy despite regular and unprotected sexual intercourse for one year, and is seen in 10% of couples in the world.

Infertility can occur in women due to problems in ovarian reserve or diseases such as endometriosis that affects the ovaries, blocked or damaged tubes, and congenital or later developing diseases that prevent pregnancy in the uterus. The primary reason can only be fully understood by being evaluated by a Gynaecologist, preferably one who can perform in vitro fertilisation treatment. In men, the main reason for infertility is the deterioration in sperm count, motility or structure, and it is challenging to understand the problem without a sperm analysis.

Infertility is a disorder that can be overcome with many treatment methods. The important thing is to correctly identify the reasons for not having children, take the necessary precautions, and apply the most appropriate treatment. For this reason, prospective mothers and fathers who want to have children should consult a Gynaecologist who can also perform in vitro fertilisation treatment. The most appropriate treatment method will be decided after basic research, such as necessary hormone tests, hysterosalpingograms, and sperm analysis.

Some hormone tests, such as FSH, LH, and E2, which show ovarian reserve, should be performed between the second and fourth days of the expectant mother’s menstrual period. The AMH test, a more effective test used to evaluate ovarian reserve, can be performed any day, regardless of menstruation. Although the milk hormone prolactin and thyroid gland hormones, which affect ovarian reserve, are performed independently of menstruation, it is recommended that these analyses be performed in the morning hours.

A semen test, or sperm analysis, is the primary test to evaluate sperm in men. For this test, a sperm sample is given after two to five days of sexual abstinence, and this sample is examined. Further, sexual abstinence is not preferred because it will cause deterioration in sperm structure. The physical and chemical structure of the sperm sample is examined, sperm count is also performed, and the vitality, motility and structure of the sperm in the semen are evaluated. The result of the evaluation is obtained on the same day.

The best time to evaluate the woman’s endometrium or the inner wall of the uterus, is between the second and fifth days of menstruation. Since the inner wall of the uterus will be thin during this period if a lesion occupies space in the uterus, it will be easily visible, and its relationship with the inner wall can be easily observed. The patient’s ovaries can also be examined during the same period because since the ovaries have just started to develop eggs, there will be no mature eggs. If there is a structure such as a cyst in the ovary, it will be easily detected. The number of antral follicles and tiny egg sacs indicating ovarian reserve can be counted on any day, regardless of menstruation. If the tubes are of normal thickness, they cannot be seen on ultrasound, and it cannot be understood whether they are blocked. A hysterosalpingography should be taken to evaluate the tubes.

Hysterosalpingography is the basic procedure used to evaluate the tubes that connect the uterus and the ovaries. In this film, the female patient lies down and poses like she will have a gynaecological examination. A liquid seen in the graph is injected into the uterus and tubes through a cannula placed in the cervix. If there is no blockage, this liquid is poured into the abdominal cavity, which causes some abdominal pain. Although this pain is momentary, it can be described as severe pain in some patients depending on the amount of fluid administered and the level of pain perception of the female patient. For this reason, hysterosalpingography can be taken under anaesthesia for greater comfort, but it is not a procedure that necessarily requires anaesthesia.

You will be in contact with your doctor, who will take care of you one-on-one before, during and after your treatment. Your coordinator, who will constantly take care of you under the control of your doctor, will continue to be the link between you and your doctor throughout the process.

According to the legal regulations in Northern Cyprus, couples are not required to be married to receive any IVF treatment.

The pregnancy rate in IVF treatment varies depending on the quality of the egg and sperm, the number and quality of the embryos formed, the structure of the inner wall of the uterus and the age of the prospective mother and father. The average pregnancy success rate in a couple who undergo IVF treatment with their eggs and no serious problems are observed is around 65%. Another critical factor that determines success in a woman who uses her eggs is the correct planning of the ovarian stimulation treatment. If there are some problems with sperm in male patients who use their sperm, some additional methods, such as sperm microchip, can be used to select higher quality sperm. Since the age factor and egg quality factor are eliminated in patients who receive egg donation, pregnancy is achieved at a rate of 70% and above at an advanced age.

The question of how many days of sperm abstinence should be in IVF treatment is a question that can sometimes lead to confusion. Since sperm is constantly produced in the male, abstinence for more than five days before giving a sperm sample will cause deterioration in the quality of the existing sperm. For this reason, it is desired to abstain from sexual intercourse for two to five days, both before the sperm test and during IVF treatment.

There is a sperm sample giving room in our IVF centre for sperm collection. The father candidate is taken to this room and puts the ejaculate fluid into the container given to him by masturbating. In advanced centres such as ours, the embryologist who will work with the sperm takes this container, which is left in a specific compartment in the sperm collection room, and the sperm in the sample is separated from the ejaculate fluid by various processes and the best sperm is selected. However, if the male patient cannot ejaculate by masturbating or if no sperm is found in the ejaculate fluid, surgical sperm collection methods can be used.

In IVF treatment, sperm is collected simultaneously with the collection of eggs; that is, while eggs are collected from a female patient or donor, the male patient also gives sperm in the sperm sample giving room and the collected eggs are fertilised with the male patient’s sperm on the same day.

The reason for this situation is important in men who do not have sperm in their semen because, in some cases, even if there is no sperm in their semen, it is possible to find sperm in the epididymis or testicles. Sperm can only be obtained from the testicles through surgical sperm collection methods. In many men who do not have sperm in their semen, it is possible to find sperm with TESE, TESA, and microTESE methods. If sperm is not found with these methods, it is possible to have a child with sperm donation in vitro fertilisation treatment.

Of course, you will be informed in advance about the tests that will be required for your treatment, and you can have these tests and examinations done where you are and send them to us.

Cyprus is one of the most appropriate countries to apply for IVF treatment because the more liberal laws and the easy use of advanced technology have put Cyprus in the top 5 in the world in IVF tourism. Currently, Cyprus serves IVF patients from all over the world and with its high success, it is increasing its reputation in the IVF leg of health tourism. Many treatments that are either not legally available or very expensive worldwide can be done legally in Cyprus and at much more affordable prices.

In addition to in vitro fertilisation treatment, the PGD/PGT procedure can be performed to determine whether the embryos are healthy for specific chromosomes, and the sex chromosomes can be observed. Since genetic diagnosis is made by taking one or more cell biopsies from the embryos in this procedure, there is no margin of error, and the result is definite. In the sperm microsort procedure, where only the sperm is separated, the margin of error is relatively high, and the microsort method is not recommended for gender selection due to the potential to damage healthy sperm genetics.

If the patients receive injection treatment, they may experience minor redness where the injections were made, which will regress within 24 hours, or they may experience some changes in their mood. Injection treatments used for egg development may cause overstimulation of the ovaries, which may cause ovarian hyperstimulation syndrome. In this case, mild bloating in the abdomen, mild pain in the groin, loss of appetite and nausea may usually be observed. If they experience any of these complaints, they should contact the doctor.

There is no limit to trying IVF treatment in Cyprus, but the motivation of the prospective mothers and fathers is one of the most critical factors here. Although pregnancy rates increase as the number of attempts increases, it is quite natural for the motivation of prospective mothers and fathers who cannot achieve pregnancy to deteriorate. Although the main goal is always to get pregnant in the first treatment, this process can be more tiring for some patients. Maintaining motivation during this process and achieving pregnancy is only possible by choosing the right centre and doctor and providing the proper support. While an increase in general success is observed in the first three attempts, when pregnancy cannot be achieved in three attempts, this situation is called recurrent IVF failure. In patients who cannot achieve pregnancy in their first attempt, some additional research should be done before further attempts, and precautions should be taken regarding the problems to be detected, which will increase the success of pregnancy in subsequent attempts.

Before IVF treatment, prospective mothers and fathers need to eat right, reduce alcohol consumption, quit smoking, if any, do regular sports, stay away from stressful environments and get regular sleep. Factors that increase the chance of pregnancy are that female patients use vitamins that contain folic acid in particular and lose excess weight, if any. Male patients need to avoid tight underwear and avoid sitting all the time. During treatment, the treatment prepared by the doctor must be followed, medications must not be interrupted, and medications must be stored at the right temperature; for men who will give a sperm sample, the sperm quality needs to be obtained through sexual abstinence is at least two and at most five days beforehand. Being comfortable during embryo transfer and transferring more than one embryo also increases the chance of pregnancy. In some IVF centres, such as ours, procedures such as embryo glue or assisted hatching can be applied to increase the chance of the embryo, i.e. the baby, which increases the chance of pregnancy.

One of the factors that most affect the success of IVF treatment with one’s eggs is the age of the mother. Just as the chance of a woman getting pregnant naturally and healthily decreases as she gets older, the chance of getting pregnant with IVF treatment will also decrease. The main reason is the decrease in the woman’s ovarian reserve. While the chance of a mother who has no additional problems and no problems in her ovarian reserve getting pregnant with IVF treatment is approximately 65-70%, a decrease in ovarian reserve is observed over the age of thirty-five, and this decrease is much more pronounced over the age of forty, affecting the chance of pregnancy. The only thing that affects the chance of pregnancy is not the egg reserve in the ovaries but the quality of the eggs obtained. As the prospective mother gets older, the rate of low-quality eggs among the existing eggs increases, which reduces the chance of having a healthy baby. Regardless of her age, personalised treatments should be prepared to obtain maximum-quality eggs from the mother.
Age is not a problem for prospective mothers who will undergo IVF treatment with egg donation. Since the uterus is an organ that is rejuvenated and immediately becomes ready for pregnancy with the treatments given, the chance of pregnancy and a healthy baby is very high, even for older mothers with in vitro fertilisation treatment with egg donation.

Since sperm production is provided regularly in men, ovarian reserve problems in older prospective mothers are not observed in male patients. However, age can also affect the sperm production of the father candidate. Especially in men over the age of forty-five, a slight decrease in sperm count and quality and difficulty in achieving pregnancy can be observed. In in vitro fertilisation treatment, selecting the best sperm from the sperm obtained with the most up-to-date and accurate methods dramatically increases the chance of a healthy pregnancy.

Regular IVF treatment consists of ovarian stimulation, collection of mature eggs, fertilisation of eggs with the father’s sperm, monitoring of embryo development and embryo transfer. In IVF treatment with egg donation, the donor’s ovaries are stimulated, and eggs are collected while the mother’s endometrium is prepared. In IVF treatment with sperm donation, the collected eggs are fertilised with the selected sperm sample.

Stimulation of the ovaries can only stimulate the maturation of the eggs that will be spent in that month, so collecting mature eggs from the ovaries does not reduce the person’s ovarian reserve.

The IVF process varies depending on the treatment performed. In the short protocol, the treatment starts between the second and fifth days of the patient’s menstrual period, and the average egg development process lasts between eight and twelve days. Then, the egg collection process is performed 34-36 hours after the trigger injection. The fertilisation process with sperm is performed on the day the eggs are collected. The embryos created are monitored for three to five days, and then the embryo transfer process is performed. In the IVF treatment with egg donation, the process of preparing the inner wall of the uterus for pregnancy, similar to the egg development process, lasts between eight and twelve days, the treatment is re-arranged on the day the embryos are created, and the embryo transfer similarly takes place within three to five days. Suppose genetic diagnosis or gender selection is to be performed with the classical PGD / PGT procedure. In that case, a biopsy is taken from the embryos on the third or fifth day, and healthy embryos are transferred according to the results obtained within one or two days.

The patients can have the first part of the IVF treatment process, egg development treatment and uterine inner wall preparation treatment, performed where they are under the supervision of our doctor. For patients who will have eggs collected, it will be sufficient to be in Cyprus before the egg collection process. If the male patient provides a sperm sample, it is sufficient for the male patient to be here only on the day the eggs will be collected. Embryo transfer is performed within 3-5 days according to embryo development monitoring, and they can return home one day after the embryo transfer. Since the treatment program is prepared specifically for the patient, the details of their stay in Cyprus will be finalised when their treatment program is determined.

It is an in vitro fertilisation application in which a sperm selected from good quality sperm is placed into the egg with a special needle, thus ensuring a high fertilisation rate.

This microchip technology allows patients with low sperm count or quality to select the best sperm in the semen. With this method, where the sperm is passed through a special chip, it is possible to increase the success of the sperm in fertilising the egg and develop better-quality embryos.

This process, also known as a genetic diagnosis in IVF, is a method that allows the detection of healthy embryos by taking one or more cells from embryos created with in vitro fertilisation treatment, that is, from babies at the cellular level, and performing some genetic tests on these cells. With this method, autosomal and sex chromosomes can be evaluated, and embryos suitable for transfer can be precisely determined.

In cases with a single gene disease or chromosomal number anomaly in the family, or the mother’s age is over 35 and the father’s age is over 45, genetic diagnosis methods are recommended to determine whether the embryos are healthy. This way, healthy babies can be found for the relevant chromosome or gene.

The collected eggs are either of suitable quality for fertilisation (M2), not yet fully prepared for fertilisation (M1), not prepared for fertilisation (GV), or abnormal in structure or shape. Of all these types of egg development, only eggs at the M2 level are suitable for fertilisation. Even if an egg appears to be of suitable quality for fertilisation, this is not a guarantee that it has a healthy genetic structure, and fertilisation may not be observed in defective eggs. In addition, since there may be defects in sperm, a genetically defective sperm may not be able to fertilise an egg.

Early menopause is a condition characterised by the ovaries ceasing to function under the age of 40 and the depletion of ovarian reserve. It is medically referred to as premature ovarian failure. This condition can occur due to chromosomal anomalies, namely genetic reasons, as well as some autoimmune diseases, some hormonal disorders, past ovarian infections, after surgery on the ovaries, or as a result of treatments such as radiotherapy or chemotherapy that affect the ovaries.

Since the only problem with early menopause is the early depletion of the egg reserve, the chance of becoming a mother using donor eggs is very high. In this treatment, eggs are collected from a donor selected according to the patient’s preference, and these eggs are fertilised with the sperm of the patient’s partner. The embryos created are transferred to the candidate mother, whose uterus is prepared for pregnancy with the help of medicines.

A woman who has entered menopause, even if her ovarian reserve is depleted, can still get pregnant with egg donation IVF treatment because her uterus is healthy. In this treatment, the eggs of a donor selected according to the patient are fertilised with the sperm of the patient’s partner, and the resulting embryos are transferred to the mother after her uterus is prepared for pregnancy.

Egg collection is a procedure performed vaginally using a special needle. It is performed under anaesthesia because it is a slightly painful procedure that requires the female patient to be still. The doctor performs an ultrasound and collects the fluids in the eggs’ sacs with a special needle during this procedure. The procedure depends on the number of sacs and takes approximately 15-30 minutes. After the procedure, the anaesthesia wears off, and the recovery process takes about one to two hours.

Egg collection is performed under anaesthesia as it requires the collection of eggs from the ovaries with a special needle, and it is expected to feel a slight pain in the groin after the procedure. This pain can be eliminated by giving painkillers after the procedure.

Egg donors never meet recipient families and never have access to recipient family information.

Since the sperm are brought from abroad with a certificate, sperm donors are not on our island, and they can never access the recipient’s family information.

The only time it is unsafe to travel during IVF treatment is immediately after the egg collection process. Travel is also not recommended on the day of embryo transfer because it increases stress. Women can travel on all days other than these two days. Travelling the day after embryo transfer does not affect the chance of pregnancy.

One of the most critical parameters affecting the pregnancy rate during IVF treatment is the number of embryos transferred. As the number of embryos transferred increases, the chance of pregnancy automatically increases. However, this time, there is a risk of multiple pregnancies, meaning that more than one baby can hold on. Multiple pregnancy is a risky situation for both the babies and the mother, so the aim should always be to increase the chance of pregnancy while not increasing the possibility of multiple pregnancies too much. The mother’s age, the number of attempts and the development level of the embryos should be considered first in the decision-making process. Transfer of up to three embryos is allowed in Cyprus. In expectant mothers under thirty-five, if it is the first attempt and some embryos develop well up to the fifth development day, a single embryo transfer should be recommended. The multiple embryo transfer option will be an application that increases the chance of pregnancy if the expectant mother is older, has a history of previous unsuccessful attempts or in patients with a slow embryo development rate.

Embryo transfer is the process of depositing selected embryos into the uterus. For this process, a special catheter is used to pass through the cervix vaginally, and the embryos are deposited into the most appropriate place in the uterus under ultrasound guidance. Embryo transfer is not a painful procedure under normal conditions, and the entire process takes about 5-15 minutes.

The day of embryo transfer is determined by the development rate and day of the embryos, and the transfer can be done between two and six days after the embryos are formed.

Resting for half an hour to one hour after the transfer is sufficient. Then, spending the transfer day at home resting and gradually returning to everyday life in the following days increases pregnancy success. It is recommended to avoid doing heavy sports, heavy work, and lifting weights until the pregnancy test.

After embryo transfer, resting for half an hour to one hour is sufficient. Afterwards, the expectant mother should gradually return to her everyday life. During this process, staying away from heavy sports and work and lifting weights is recommended until pregnancy occurs. However, it is not recommended to lie down constantly because lying down constantly increases the stress level of the expectant mother and can make it difficult for the pregnancy to occur. There is no harm in traveling the day after embryo transfer if there is a journey. In addition, coughing, sneezing, climbing stairs, lying face down, and taking a bath do not negatively affect the pregnancy. In terms of nutrition, it will be sufficient to avoid all harmful products for a pregnant woman to consume, eat healthily, and drink plenty of water. Only the treatments the doctor recommends should be entirely applied during this process, and additional medications should not be used without consulting our doctor.

In IVF, the pregnancy test is determined by a pregnancy test performed on the blood twelve days after embryo transfer. The level of the B-HCG substance measured in the blood, which belongs to the baby, definitely tells whether the person is pregnant or not. No matter the test result, the result must be shared with the doctor. Another mistake made regarding the test is to stop taking the medication on the day of the test. However, the supportive treatment that will ensure the continuation of the pregnancy should not be stopped if there is a pregnancy. Therefore, it is essential to continue taking the medication and act according to the doctor’s recommendations.

The risk of miscarriage in IVF pregnancy is not higher than in naturally conceived women; in fact, the fertilisation process in IVF treatment is much more meticulous, and the sperms are carefully selected from the sperm sample taken, and the best embryos are transferred, so the chance of having a healthy baby may be higher. The continuation of success in IVF pregnancy depends on the regular use of the recommended medicine supports.

The probability of multiple pregnancies in IVF treatment is higher than spontaneous pregnancies. The main reason is that more than one embryo may be transferred to the mother to increase the chance of pregnancy. The development day of the transferred embryo can also affect the probability of twin pregnancy because the probability of a fifth-day embryo to implant is higher than the probability of a third-day embryo, and the mother and father candidates should decide together with their doctors how many embryos will be transferred by calculating these probabilities. However, it should be kept in mind that even if more than one embryo is transferred, the majority of IVF pregnancies will still be singleton pregnancies.

The number of embryos transferred should be carefully chosen to prevent multiple pregnancies. No intervention is usually recommended for twin pregnancies. The risk of triplet pregnancies is shallow, but in the case of triplet pregnancies, embryo reduction is recommended so that one or two babies can live a healthy life.

Although minor differences can be observed in some cases, in general, there is no increased risk in terms of the baby’s health in IVF pregnancies compared to spontaneous pregnancies. However, it should be remembered that if there is a genetic defect in the mother or father, this defect can also be passed on to the baby.

It is expected to have a slight spotting after the egg collection process of IVF treatment, but bleeding afterwards is not an expected situation. Not every vaginal bleeding necessarily means that pregnancy has not occurred. Most of the bleeding can also occur when the transferred embryo, that is, the baby or babies in the cellular stage, attaches to the inner wall of the uterus, and sometimes bleeding can be observed due to some hormones that are missing in the inner wall of the uterus, and with the suitable precautions, diagnosis and treatment, the chances of the babies attaching can be increased and the pregnancy can be continued with the necessary intervention without miscarriage. Despite all precautions, some embryos may not attach, and the treatment may end with the pregnancy not developing or early pregnancy loss. In case of bleeding, medical support must be sought in order to increase the chances of pregnancy.

Since IVF treatment causes some changes in hormones, this effect must first disappear, and this process can take between one or two months. Additional tests may be requested during this waiting period to determine why pregnancy has not been achieved. In addition, the psychological recovery of the mother and father candidate after an unsuccessful attempt is essential for the success of the subsequent treatment.

The excellent quality of an embryo does not always mean it is genetically normal, and genetically defective embryos have a lower chance of implantation. In addition, the endometrium, or the inner lining of the uterus, is as important as embryo quality. Despite all efforts, a genetically tested healthy embryo may not implant in a good endometrium. This may be due to improper use of medications, as well as intense anxiety and stress.

The probability of ectopic pregnancy in IVF treatment is slightly higher than spontaneous ectopic pregnancy, around 1-2%.

Created embryos can be frozen from the day they are fertilised until the sixth day of their development, but the freezing process is often done on the third and fifth days of development when the chance of pregnancy is higher.

In IVF treatment, with the proper treatment, more embryos are often formed than needed in number and quality. It is always recommended to freeze these embryos for later use because if pregnancy is not achieved in the first attempt, having embryos in hand will provide a chance for repeat treatment at a much lower cost. If pregnancy is achieved, it will give the mother-to-be the chance to have siblings with a very high success rate and almost no effort. Contrary to popular belief, frozen embryos are most likely not damaged by this freezing process (90% and above). In frozen embryo transfer, if the embryos are of good quality, the mother-to-be is calmer and more conscious, so the chance of pregnancy is slightly higher than in fresh IVF treatment.

Having a healthy body is a factor that significantly increases the chance of pregnancy; therefore, the mother’s diet is also vital. In expectant mothers planning to have an egg collection, it is recommended to increase the consumption of green vegetables, fruits, whole wheat bread, unsalted nuts, fish, and olive oil, which will increase egg quality, ideally starting 2-3 months before the treatment. In order for the inner wall of the uterus to thicken appropriately, it is also recommended to consume unsalted nuts, avocado, fish, spinach, peanuts, red bell peppers, whole wheat bread, pumpkin, and sunflower oil, starting at least 1 month before the treatment. In addition, margarine, processed foods, salt, and sugar are among the foods that should be avoided.

Sperm production is a continuous process, and the time between the first production of a sperm cell and its maturation is approximately 62 days. For this reason, fathers-to-be who aim to increase sperm count and quality should start paying attention to their diet at least 2 months before giving a sperm sample. Foods that increase sperm count and mobility are green leafy vegetables, fish, beef, legumes, walnuts, avocados, bananas, blueberries, pomegranates, oranges, tomatoes and bell peppers. Foods that are not recommended because they reduce sperm count and quality are caffeine, soy sauce, full-fat dairy products, and processed meat (e.g. sausage).

For a successful IVF treatment and a healthy pregnancy process, being in the normal weight range is an element that increases success. Although there is no definite weight range, it is necessary to be in the average body mass index; that is, it is preferred that the expectant mother have a weight that seems typical for her height. Being overweight or too thin makes it challenging to adjust the medications used during the pregnancy process and puts the continuation of the pregnancy at risk. What needs to be done is for the expectant mother to eat regularly, exercise and stay away from cigarettes and alcohol as much as possible from the moment she plans to get pregnant.

Sexual intercourse does not adversely affect embryo transfer, but spotting may occur after intercourse due to the procedures and medications used during the treatment process. Since conditions such as spotting and pain may cause anxiety in the prospective mother and father, it is recommended that couples abstain from sexual intercourse after embryo transfer, at least until the pregnancy test. In couples who have had genetic screening of embryos with PGD / PGT, sexual intercourse is not recommended because spontaneous pregnancy is not desired.

One of the most frequently asked questions after embryo transfer is how much movement should be restricted. It has been shown that lying down for a long time after embryo transfer does not increase pregnancy success and even decreases it. Constantly lying down until the day of the pregnancy test will also increase the stress level of the expectant mother and may adversely affect the development of pregnancy. For this reason, expectant mothers are asked to rest for an hour after the transfer and then return to their daily lives. Until the day of the pregnancy test, the expectant mother can do all the movements a pregnant woman can do, walk in a way that will not tire her, and only stay away from heavy work and lifting weights.